Download Chap. 18b Elderly Clients

Chap. 18b Elderly
Clients
Exercising the Elderly
Introduction
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The baby boomer generation is now
becoming a large percentage of the
elderly population
As more people become senior citizens the
need for increased fitness levels is
necessary
Most people are considered seniors at the
age of 50+, however be careful in that
determination as it does not fit many
people that age
Older Adults
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When working with older adults it is
common to have clients with various
medical conditions
Cardiovascular disease, diabetes,
osteoporosis, low back pain, obesity,
and general frailty.
Make sure to seek out physician
approval for exercise participation
Older Adults
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Health Benefits of Senior Exercise
• Aerobic Training
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Exercises such as walking, jogging and
cycling improve cardiovascular fitness
Reduced body weight from aerobic
conditioning may lessen high blood pressure
risk, type 2 diabetes and obesity
Reduced psychological stress
Improved sleep
Improved digestion and elimination
Older Adults
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Health Benefits of Senior Exercise
• Aerobic Training
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Reduced risk of cardiovascular disease,
stroke, osteoporosis, certain types of
cancer, and phychological stress
Increases in the gray and white matter in
various regions of the brain after six months
of training.
Older Adults
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Resistance Training
• Cardiovascular Disease
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How does resistance training lower risk of
cardiovascular disease? (4 ways)
• Decreases body fat
• Decreases resting blood pressure (systolic,
diastolic or both
• Improvement in blood lipid profiles
 Significant decreases in LDL’s
• Enhances vascular condition, which facilitates
circulation and arterial blood flow
Older Adults
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Colon Cancer
• Slow gastrointestinal transit speed
appears to be associated with an
increased risk of colon cancer
• Aerobic exercise and resistance training
have been shown to speed up GT speed
• Exercise in general can be used as an
effective intervention for age-related GT
movement
Older Adults
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Type II Diabetes
• Increased sedentary lifestyle among people
has contributed to tremendous increases in
type II diabetes among men and women
• Resistance training has been shown to utilize
glucose better in terms of uptake in diabetic
patients
• Increased exercise levels among adults can
preserve lean body mass thereby reducing
muscle myopathy, ultimately leading to
reduced risk of type II diabetes
Older Adults
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Osteoporosis
• A degenerative disease of the skeletal
system resulting progressive bone
protein and mineral loss
• Regular resistance training can take
bone loss and change it to bone gain in
elderly clients
Older Adults
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Low Back Pain
• Not a life-threatening condition, but still
very serious as it is the most prevalent
medical problem in the United States
(why do you think this is?)
• Correlation between weak low back
muscles and low back pain
• Resistance training that strengthens low
back muscles may lessen or alleviate
the pain in some clients
Older Adults
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Arthritis
• Stronger muscles may improve joint
function and reduce the discomfort
associated with arthritis
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Depression
• Significant reductions in depression
have been seen in clients after 10
weeks of resistance training
• Why would exercise in general be good
psychologically for elder clients?
Older Adults
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Muscle Loss and Metabolic Rate Reduction
• One of the greatest benefits of resistance
training for seniors is the replacement of
muscle tissue and recharging of the metabolic
process
• These have been shown to be probably the
most severe problem of aging men and women
• Adult men and women lose about one half
pound of muscle per year during their 30’s and
40’s (called sarcopenia)
• Rate of 1 pound per year of muscle loss is
possible in adults 50 yrs of age or older
Older Adults
• Muscle Loss and Metabolic Rate
Reduction
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Each decade of life Americans add around
10 pounds of body weight, however, its
really 5-10 pounds less of muscle and 15-20
pounds of fat!
Slow resting metabolic rate is also due to
this increase…slow resting metabolism
means calories used for energy before for
high energy muscles are now used to store
fat
Older Adults
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Muscle Loss and Metabolic Rate Reduction
• Resistance training can maintain muscle tissue
to continue physical activity and enhance
energy utilization by body throughout the
senior years
• Resistance training is the ONLY type of
exercise that can maintain muscle and
metabolism as people age
• It is imperative that it is the essential
component of the senior fitness program
Older Adults
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Resistance Training Guidelines for Seniors
• Include:
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2-3 non-consecutive days per week
Single and multiple joint movements
Single or multiple sets
Variety of exercises using major muscle groups (quads,
hamstrings, pecs, lats, biceps, triceps, deltoids, etc.)
Controlled exercise speeds (4-6 sec. per repetition
Resistance training range can be 60-90% (4-16 reps) of maximum
depending upon ability and health
Older adults are advised to begin their strength training program
with exercise resistances that permit 10 to 15 repetitions,
corresponding to approximately 75-60% of 1RM.
Give competent instructions and careful supervision
Older Adults
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Instructional Model for Training/Teaching
Seniors
• Demonstrate how the exercise is performed
• Explain precisely each movement phase and
the proper breathing pattern
• Demonstrate the exercise again with emphasis
on exhaling during the lifting phase and
inhaling during the lowering phase
• Provide positive reinforcement for correct
technique with specific feedback and
suggestions for improvement
Older Adults
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Aerobic Endurance Training
Guidelines for Seniors
• 2-5 days per week
• 20-60 minutes per session
• 60-90% of maximum heart rate, however,
training usually around 75%
• Assess exercise intensity in older adults by
heart rate and RPE (Borg) scale
 75% max HR = 12-14 RPE
• Talk test is another way to assess exercise
intensity in senior citizens
Older Adults
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Aerobic Endurance Training
Guidelines for Seniors
• For older adults with limited cardiorespiratory fitness
they may begin with only 5 to 10 minutes of physical
activity at approximately 40% of maximum heart rate.
• ASCM and the AHA present two aerobic training
protocols that can be exclusive or performed together:
 30 min. of moderate intensity endurance exercise
(walking) five days a week
 20 min. of vigorous intensity endurance exercise
(jogging) three days a week
Older Adults
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Screening and Program Design for
Seniors
• First step is to check with the client’s
personal physician for specific exercise
guidelines and training modifications
• Be observant for any exercise
contraindications or undesirable
responses
• Keep careful and detailed record of
exercise sessions and fitness
assessments
Older Adults
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Exercise Order
• If doing both aerobic and resistance training
exercises…always begin with aerobic activity
first (including warm up and cool down phases
of course)
• Resistance training would be next in order and
concluding with static stretching
• If they only do resistance training then a light
5-10 minute aerobic warm up is sufficient,
then flexibility is necessary after resistance
training
Older Adults
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Safety and Comfort (table 18.1, pg. 476)
• Certain conditions associated with elderly clients can
cause discomfort during exercise…let’s look at a few:
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Dry Skin: apply lotion to elbows, knees, etc. before
exercising
Poor Balance: weight supported resistance and aerobic
machines first before free weights and treadmill walking,
etc. Avoid hard to control exercises (e.g. lunges), seated or
lying position instead of standing if need be
Propensity for Injuries: train in uncluttered facility,
controlled movement speeds, proper posture
Susceptibility to Cold and Flu: drink plenty of fluid, obtain
ample rest, shower after exercise
Reduced flexibility: warm up well before exercise,
appropriate stretching exercises at end of training session
Difficulty Seeing or Hearing: speak clearly and concisely
with sufficient volume, use large print materials and cards,
frequently ask clients if they understand
Reduced Tolerance for Heat: climate controlled facilities,
training sessions early in the day, light colored clothing and
drink plenty of fluids